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New Product Slideshow
Soliqua 100/33 (insulin glargine, lixisenatide)
Introduction
Brand name: Soliqua 100/33
Generic name: Insulin glargine (rDNA origin), lixisenatide
Pharmacological class: Human insulin analog + glucagon-like peptide-1 (GLP-1) receptor agonist
Strength and Formulation: 100 Units/mL + 33mcg/mL; soln for SC inj; contains m-cresol
Manufacturer: Sanofi aventis
How supplied: SoloStar prefilled pen (3mL)—5
Legal Classification: Rx
SOLIQUA
Indications
As adjunct to diet and exercise, to
improve glycemic control in adults with type 2 diabetes mellitus inadequately controlled on basal insulin(
Limitations of Use
Not studied in patients with history of unexplained pancreatitis; consider other antidiabetics
Not for use with other lixisenatide- or GLP-1 receptor agonist-containing products
Not for treating type 1 diabetes mellitus or diabetic ketoacidosis
Not recommended in gastroparesis Not studied in combination with prandial
insulin
Dosage & Administration
Discontinue lixisenatide or basal insulin prior to initiation
Give by SC inj once daily within the hour prior to first meal into thigh, upper arm or abdomen; rotate inj sites
≥18yrs: individualize; monitor and adjust as needed
Inadequately controlled on
Dosage & Administration
Titrate dose by 2–4 Units weekly until desired FPG achieved; max 60 Units
If 60 Units daily required: use alternative antidiabetic products
Switching from basal insulin or lixisenatide: see full labeling
Considerations for Special Populations
Pregnancy: Use only if potential benefit justifies potential risk to the fetus
Nursing mothers: Consider benefits and adverse effects
Pediatric:
Contraindication
During episodes of hypoglycemia
Warnings/Precautions
Instruct patients on diet, exercise, blood testing, proper administration of insulin, and management of hypoglycemia
Do not reuse or share pens, needles, or syringes between patients
Discontinue if hypersensitivity reactions occur
Warnings/Precautions
Monitor for signs/symptoms of pancreatitis; discontinue if suspected; do not restart if confirmed
History of pancreatitis: consider alternative antidiabetics
Increased risk of hypo- or hyperglycemia if changes in physical activity, meal patterns, renal or hepatic function, insulin regimen and if acute illness occurs: monitor glucose more frequently and may need to adjust dose
Warnings/Precautions
Monitor potassium levels in patients at risk for hypokalemia (eg, concomitant K+-lowering or K+- sensitive drugs)
Renal impairment or severe GI reactions: monitor and avoid fluid depletion
Elderly
Interactions
Do not mix or dilute with other insulins or solutions
Concomitant thiazolidinediones (TZDs) may cause fluid retention and heart failure; consider dose reduction or discontinue TZDs
Potentiated by antidiabetic agents, ACE inhibitors, ARBs, disopyramide, fibrates, fluoxetine, MAOIs, pentoxifylline, pramlintide, propoxyphene, salicylates, somatostatin analogs, sulfonamide antibiotics
Interactions
Antagonized by atypical antipsychotics, corticosteroids, danazol, diuretics, estrogens, glucagon, isoniazid, niacin, oral contraceptives, phenothiazines, progestogens, protease inhibitors, somatropin, sympathomimetics, thyroid hormones
Variable effects with β-blockers, clonidine, lithium salts, alcohol, pentamidine
Interactions
Concomitant β-blockers, clonidine, guanethidine, reserpine may blunt hypoglycemia
Concomitant antibiotics, APAP, other drugs dependent on threshold concentration: administer ≥1hr before Soliqua; for oral contraceptives, take ≥1hr before or 11hrs after Soliqua
Adverse Reactions
Hypoglycemia
Allergic reactions
Injection site reactions
Nausea
Nasopharyngitis
Diarrhea
Upper respiratory tract infection
Headache
Lipodystrophy
Weight gain
Hypokalemia
Mechanism of Action
Insulin and its analogs lower blood glucose by stimulating peripheral glucose uptake and by inhibiting hepatic glucose production
Lixisenatide increases glucose-dependent insulin release, decreases glucagon secretion, and slows gastric emptying
Clinical Trials
A randomized, active-controlled, open-label, 2-treatment arm, multicenter study (n=736) compared the safety and efficacy of Soliqua 100/33 vs. insulin glargine 100 Units/mL
At Week 30, there was an HbA1c reduction from baseline of −1.1% for Soliqua and −0.6% for insulin glargine
Clinical Trials
The mean difference in HbA1c reduction between Soliqua and insulin glargine was −0.5 [95% CI: −0.6, −0.4]
For more clinical trial data, see full labeling
New Product Monograph
For more information view the product monograph available at:
http://www.empr.com/soliqua/drug/34632/